| Mickaella Moreta Corp | |
|
2401 University Pkwy Bldg 1 Suite 203 Sarasota FL 34243-2893 | |
| (941) 351-2221 | |
| (941) 761-6903 |
| Full Name | Mickaella Moreta Corp |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2401 University Pkwy Bldg 1, Sarasota, Florida |
| Authorized Official Name and Position | Mickaella Moreta (PRESIDENT) |
| Authorized Official Contact | 9413512221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mickaella Moreta Corp 2401 University Pkwy Bldg 1 Suite 203 Sarasota FL 34243-2893 Ph: (941) 351-2221 | Mickaella Moreta Corp 2401 University Pkwy Bldg 1 Suite 203 Sarasota FL 34243-2893 Ph: (941) 351-2221 |
| NPI Number | 1790198463 |
|---|---|
| Provider Enumeration Date | 06/10/2014 |
| Last Update Date | 12/30/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790198463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PPY185 (Florida) | Primary |
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